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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2008;28:s33.)
© 2008 American Heart Association, Inc.

Translational Therapeutics at the Platelet Vascular Interface: A CME-Certified Activity

P2Y₁₂ Antagonism

Promises and Challenges

Alan D. Michelson

From the Center for Platelet Function Studies, Departments of Pediatrics, Medicine, and Pathology, University of Massachusetts Medical School, Worcester.

Correspondence to Alan D. Michelson, MD, Director, Center for Platelet Function Studies, University of Massachusetts Medical School, Room S5-846, 55 Lake Avenue North, Worcester, MA 01655. E-mail michelson{at}platelets.org

Abstract

The P2Y₁₂ antagonist clopidogrel has a well-established role as an antithrombotic agent in the settings of percutaneous coronary intervention and acute coronary syndromes. However, several challenges remain, including the relatively slow onset of action of clopidogrel and the phenomenon of clopidogrel response variability or "resistance". Novel P2Y₁₂ antagonists, including prasugrel, AZD6140, and cangrelor, have a faster onset of action, as well as more potent, and less variable, inhibition of platelet function ex vivo. Whether this promise will be translated into clinical benefit for patients will be determined by the results of ongoing phase 3 clinical trials.

Key Words: platelets • clopidogrel • prasugrel • AZD6140 • cangrelor